A Publication for Friends and Patients of The Everett Clinic

SPRING 2015

everettclinic.com

New Pain Therapy Treatment Keeps Pilot AloftIn March, financial advisor

Dale Terwedo, 55, owner of TFS Advisors, LLC, of Edmonds, celebrated a milestone—five years cancer free. These days his risk of getting colon cancer is the same as anyone else’s.

Dale beat cancer, but there was a price. A chemotherapy drug left him with lingering, painful neuropathy in his feet and legs.

Imagine the pins and needles when your foot falls asleep. Then imagine those pins and needles are burning. Imagine your feet at the end of a long hike in too small boots.

“It’s like walking on exposed aggregate concrete in summer,” Dale said.

He takes a hefty dose of B vitamins to try to ease the pain and he could take medication for relief—but he won’t.

“If I did, I couldn’t fly,” he said. Dale is a pilot. It’s one of his joys and it’s a way to give back. He’s an Angel Flight pilot, providing free transportation for people who need medical care. “I’ve always been an active adventurer. I try new things, see new places.”

So, when Dale’s oncologist told him about a new treatment that might cure the pain but didn’t involve drugs, he jumped on it.

“I didn’t expect insurance to cover it, but I didn’t care,” he said.

The Calmare® Pain Therapy Treatment uses disposable electrodes at the area of greatest pain to transmit a “no-pain” message to the nerves. It requires several daily treatments, but is painless.

“Our new Calmare® treatment is the most effective measure that I have seen in over 30 years of treating cancer patients,” said Dr. James Congdon, an oncologist with The Everett Clinic. “This non-invasive procedure has often been able to reverse painful and debilitating neuropathy symptoms and return people to pain free, productive lives. It has proven effective even for patients whose symptoms have not responded to other standard treatments.”

For some people, the pain recedes, even goes away, after a treatment or two. That wasn’t Dale’s experience but, after several treatments (12 in all), he did notice a difference.

“I experienced about a 70 percent reduction of the acute pain. There’s still some numbness and stiffness,” he said.

But it’s better. He can fly. He can get a good workout at his racquetball game two days a week, along with other workouts. He can put his feet under the sheets again. And, although he was prepared to pay for the treatment out of pocket, his insurance did come through.

He plans to get a booster round of treatments soon.

“It was worth it. It helped,” he said.

For years, my wife used to tell me to go to bed early. I used to tell her that I needed time to unwind, but the truth was I liked watching movies. Instead of getting 7-8 hours, I used to get only 5-6 hours

of sleep. She used to call me a hypocrite as I spent my days telling my patients about the importance of sleep.

In my late thirties, I started to gain weight, my blood pressure started to climb and I was slowly becoming irritable, impatient and ill-tempered.

Two years ago, I don’t exactly know why, I started getting 30-60 minutes more sleep every night. I began noticing many wonderful things happening to me! Both my

weight and blood pressure started to come down. I am almost off all my blood pressure medications. I am waking up full of energy. Even after 10 hours of helping patients I have energy to go to the gym to workout. In my 18th year of practice I find myself loving being a doctor more than ever, and my family is grateful for my newfound pleasant temperament.

I really wish I had taken my own advice many years ago. Getting good sleep and treating sleep problems, such as snoring and apnea, has been shown to decrease the risk for high blood pressure, diabetes, obesity, heart attacks, heart rhythm problems (which end up requiring life long blood thinners and sometimes pacemakers), heart failure, strokes, arthritis and even cancer.

I truly believe getting good sleep and enough of it every night is the most important thing we can do to improve our health. During sleep our body rests and repairs itself. By not getting enough sleep our bodies age prematurely.

Sweet dreams!

If you think you need a sleep evaluation,

call one of our board certified pulmonary and

sleep specialist physicians at 425-339-5410.

Confessions of a Pulmonary Sleep PhysicianBy Dr. Sridar Chalaka The Everett Clinic Pulmonary and Sleep Medicine

Dr. Steve Martinez,

a fellowship-trained breast surgical oncologist at The Everett Clinic says,

“Almost as important as the ability for 3D mammography to identify breast cancer is

its ability to tell doctors when it’s not

there.”

A screening mammogram typically only takes 15-30 minutes from start to finish.

Cancer survivor Dale Terwedo (right) is an Angel Flight pilot, providing free transportation for people who need medical care. He’s pictured here with this son, Aaron (left).

Ask your oncologist about Calmare® for the treatment of the following issues:

■■ Chemotherapy-induced peripheral neuropathy (CIPN)

■■ Phantom limb syndrome

■■ Sciatica

■■ Post-surgical neuropathic pain

■■ Low back pain

■■ Neck pain

■■ Reflex sympathetic dystrophy

■■ Postherpetic neuralgia (PHN)

Early detection is the key to breast cancer survivorship. A screening

mammogram is a low-dose X-ray used to evaluate a woman’s breast health. It helps doctors see whether there are any abnormalities or changes in the breast tissue that may need treatment. With this in mind, we’re finding ways to better detect breast cancer with three-dimensional mammography screenings.

What is a 3D mammography screening?It’s an X-ray that takes multiple images of your breast tissue. The images are then converted to a 3D image that allows the radiologist to see the tissue in greater detail.

Does a 3D mammogram still compress the tissue?Yes, but there is no additional compression of the breast tissue and it only takes a few more seconds for each view.

Will I be exposed to more radiation?3D mammography uses a very low X-ray dose during the exam, about the same amount as a traditional mammogram done on film.

Benefits of 3D mammograms■■ It allows your doctor to examine your breast tissue layer by layer.

■■ There is less chance of being called back for another look.

■■ It detects more invasive breast cancers and reduces false

positives. This means one simple thing: early

detection.

3D mammography screenings will be available at Smokey Point, Everett (Founders Building)

and Mill Creek by mid June 2015. For

more information, call 425-317-3400 or visit

everettclinic.com/3d-mammo.

Seeing more in Coming soon to The Everett Clinic: 3D Mammography Screenings!

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Community ClassesSupporT · WEl lnESS · In ForMAT Ion

Yomi Adekeye, MDOccupational MedicineEvErETT425-339-5489

Denise Blackwell, PTPhysical TherapyEvErETT425-339-5419

Kendra Blosser, PA-COrthopedicsEvErETT425-339-5447

Sue Carmody, ARNPFamily MedicineSTAnWOOD360-629-1504

Megha Chadha, MDBehavioral HealthEvErETT425-339-5453

Emily Cheng, MDInternal MedicineSILvEr LAkE425-357-3301

Katherine Clawson, MDFamily MedicineEvErETT425-339-5456

David Collins, PA-C OrthopedicsEvErETT425-339-5447

Martha Cramer, MPTPhysical TherapyEvErETT425-339-5419

Barbara Hinchcliffe, LHBehavioral HealthEvErETT425-339-5453

YuJin Kim, DOFamily MedicineLAkE STEvEnS425-397-1704

Dianne Kutzke, ARNPFamily MedicineFOunDErS425-339-5456

Diane La Freniere, ARNPFamily MedicineMArYSvILLE360-651-7495

Lisa Mulligan, MDEar, nose & ThroatEvErETT425-339-5441

Aaron Newton, PA-CHeart & vascularEvErETT425-339-5411

Paul Reynolds, MDOrthopedics & Sports MedicineEvErETT425-339-5447

Nancy Sharma, MDOncologyEvErETT425-297-5500

Lisa Shen, MDPediatricsMArYSvILLE360-651-7492

Rebecca Webb, PhDBehavioral HealthEvErETT425-339-5453

Tyler Wipf, PA-COrthopedicsEvErETT425-339-5447

TEC Weight Loss for LifeEverett | Beginning Tuesday, September 8, 5:30 - 7 pmThis seven-week behavior-based wellness program is designed to help you:

■■ Become aware of the associations of feelings and food ■■ Learn mindfulness as a stress-reduction technique to use while eating

■■ Learn hypnosis to develop a healthy relationship with food

Cost: $150. To register, visit everettclinic.com/classes. For more information, call: 425-304-1140.

Research shows that obesity is one of four major but modifiable risk factors for heart disease. Set lifestyle goals this spring to help prevent heart disease.

Your Life, Your WishesEverett | Wednesday, June 10, 1 – 3 pm, or Saturday, July 11, 10 am – 12 pmThis complimentary course covers the difficult decisions faced as the end of life nears. These matters can be hard to discuss, but having conversations ahead of time can ensure the best of care. Includes FIvE WISHES™, advanced directives, power of attorney and POLST forms, and other end of life related issues. To register visit everettclinic.com/classes, or call: 425-339-4281.

DBT Skills Training GroupEverett or Smokey PointDialectical Behavior Therapy skills can help people live happier, healthier lives. A referral from your Behavioral Health provider is required to join this six-month training course. To register, call: 425-339-5453.

Take five! Taking breaks throughout the day, especially ones including movement, can have a positive impact on your physical and mental health by reducing stress and improving circulation.

Newborn BasicsEverettJoin our pediatricians as they help you prepare for your newborn’s first few months of life. Topics include: feeding, sleeping, soothing, signs of illness and more. To register visit everettclinic.com/classes, or call: 425-258-3900.

Dementia Caregiver Support GroupEverett or Smokey PointThis free support group provides a caring place for caregivers and is open to all care partners, family and friends of individuals with dementia or memory loss. To register, call: 425-317-3482.

Conquering AnxietyEverettLearn skills and strategies for managing anxiety, including: relaxation techniques, mindfulness and acceptance, challenging negative thoughts and coping with panic attacks. To register, call: 425-339-5453.

A sense of humor, a positive attitude and enjoying time with family and friends can improve your outlook. Try spending a few minutes today doing something that makes you laugh or smile!

Teen Skills GroupMill CreekFor teens ages 13-17, this group focuses on anxiety, depression and your peers. Develop skills to manage anger, anxiety and depression more effectively and learn about conflict resolution. To register, call: 425-339-5453.

Getting Better GroupThe Getting Better Group is for those dealing with pain (chronic or injury related) or other physical symptoms that affect their mental and emotional health. Learn to cope with anxiety and depression related to your physical symptoms. To register, call: 425-339-5453.

The Everett Clinic offers a variety of classes and support groups throughout the year. For a complete list, visit everettclinic.com/classes.

DETECTIng Vascular Diseaseby Dr. Mahesh Mulumudi The Everett Clinic Heart & Vascular Center

Welcome New ProvidersFor detailed information, visit: everettclinic.com/physicians

EvErETT■ ■■ HArbour poInTE■ ■■ SMokEy poInT425-339-5436 | everettclinic.com/vision

Coupon valid through 06/26/15. Cannot be combined with any other offer or discount. not compatible with most insurance plans.

Get a new look for spring!

Nine West, Valentino, Nike and Flexon frames with lens and frame purchase.

veins and arteries run throughout your entire body and any issue with them, called vascular disease, can affect any part

of your body. When a vascular condition affects the arteries to the brain, it can cause strokes. If the arteries in the legs are affected, you could have severe leg pain and ulcers that don’t heal.

varicose veins can be a serious issue, not just a cosmetic annoyance. If the varicose veins are associated with swelling in your legs, leg pain when you stand or walk or if you have non-healing or slow to heal ulcers, then it is important to have your legs checked for venous flow.

venous flow, or the flow of blood through your arteries, can be painlessly measured. Blood pressure is measured in the legs and then compared to the blood pressure measured in your arms. These measurements will be equal in someone with a healthy venous system. If there are indications that there are problems with the vascular system, there are treatments available that can help keep you healthy. Detection will help determine treatment.

Bring in this coupon for 3O%OFF

There are several factors that increase your risk of developing a blockage of the arteries including:

■■ use of tobacco and smoking■■ Diabetes■■ Genetic makeup

If you use tobacco products, make a plan to stop. If you have diabetes, learn to manage and control your disease. Prevention is always the first step in avoiding serious health issues.

For more information on the detection of vascular disease, talk to your primary care provider about a referral to The Everett Clinic Heart & vascular Center.

Dr. Mahesh Mulumudi is an interventional cardiologist on our Heart & Vascular Team. He is board certified in Internal Medicine, Cardiovascular Disease and Nuclear Cardiology.

Prevention is always the f¡rst step in avoiding serious health issues.

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Online AppointmentsEasily make pediatric appointments through

MyChart.Learn more on

page 4

Oh Baby!Moms, we’d love to help deliver your baby! Make us your maternity team for pre-pregnancy, prenatal and post-partum care. We offer a free newborn basics class for all of our expectant mothers. Find out more: call 425-339-5430 or visit everettclinic.com/OB.

The Everett Clinic now offers cryoablation for the minimally invasive treatment of breast fibroadenomas (solid, noncancerous breast tumors that are usually painless and vary in size). Although a fibroadenoma is not life-threatening, treatment may be desired because this benign tumor can cause physical deformity, discomfort or emotional distress.

Traditionally, surgery has been the only option, but now, a minimally invasive option is available that can be performed in the office under local anesthesia.

IceCure cryoablation is the use of extreme cold to destroy a breast tumor without surgery. A thin metal probe is passed through the center of the tumor with the assistance of ultrasound guidance. The tip of the metal probe is cooled to extremely low temperatures (-256°F). This freezes and kills the breast tumor without harming the surrounding tissues and without any significant scarring.

GET THE FACTS. Cryoablation:■■ Is done in the office. A breast surgeon confirms the presence of a fibroadenoma via an examination, breast ultrasound and core needle biopsy. Then, if needed, the cryoablation is scheduled.

■■ Does not require general anesthesia. After injection of a local anesthetic, ultrasound monitoring is used to help guide a two millimeter metal probe into the center of the fibroadenoma. The tip of the probe is then cooled to extremely low temperatures, which turns the tumor into a small ball of ice, and kills it. This takes about 15 minutes. Then, the metal probe is removed.

■■ Is minimally invasive. The patient may immediately resume normal activities after the procedure. Most people report minimal discomfort during or after cryoablation and take only acetaminophen (Tylenol) after cryoablation.

■■ Is an FDA approved, safe and effective alternative to surgery. Advantages include: a shorter incision (two millimeters), local anesthesia, a shorter procedure and office visit (about one hour total) and less time missed at work (usually less than a day). Cryoablation for fibroadenomas is approved by the u.S. Food and Drug Administration (FDA). Since 2010, more than 2,000 fibroadenomas have been successfully and safely treated with this method.

■■ Is covered by many health insurance companies for benign breast tumors. The Clinic will work with a patient’s insurance company to determine coverage and approval prior to the procedure.

Surgical oncologist Dr. Steve Martinez is a breast and endocrine surgeon on our cancer care team trained in advanced and minimally-invasive techniques in breast surgery, including cryoablation for breast fibroadenomas.

Dr. Laurent Nicolov with Beckett McBride Swobody born June 10, 2014.

Dr. Nariman

Heshmati with

one of his little

deliveries.

IceCure: New treatment for benign breast tumorsby Dr. Steve Martinez The Everett Clinic Surgical Oncology

BirthNewborn

BasicsPrepare for your

newborn’s first few months of life.

See community classes on page 2

Saturday Pediatric ClinicConvenient Saturday

pediatric care. Visit everettclinic.com/peds

Our Parent’s Guide

can help you through each stage of your

children’s growth. Find it at everettclinic.com/peds.

ADHD ClinicOur ADHD clinic focuses on providing care for pediatric patients from their time of diagnosis throughout their

early college years.Visit everettclinic.com/ADHD

Walk-In Clinics

Convenient, prompt medical care when your kids need it!

Visit everettclinic.com/WIC

Teen Skills Group

Help with anxiety, depression and conflict

resolution for teens.Find out more on

page 2

WLFL ClassTEC Weight Loss for

Life is a seven-session behavior-based

Wellness Program. See community classes

on page 2

Sports MedicineSports medicine focuses

on prevention, recognition, management and rehabilitation

of injuries that occur during participation in sports,

exercise and recreation. Find out more on page 4

Primary CareIf you don’t currently have a primary care provider (PCP) for your ongoing medical care, now is a

great time to create that relationship.

Visit everettclinic.com/PCP

End of Life CareLearn about the medical

decisions people face at the end of life and how to complete

some important advance directive forms.

Visit everettclinic.com/classes

Afib ClinicOur Atrial Fibrillation Clinic is dedicated to the evaluation and

management of patients with atrial fibrillation.Visit everettclinic.com/afib

MedicareLearn how

medicare advantage benefits you.

Visit everettclinic.com/medicare

AdulthoodAdolescenceFrom Pediatrics to Geriatrics: We're here for you through every stage of life.

Late Adulthood

3901 Hoyt Avenue ■ Everett, WA 98201 ■ everettclinic.com

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Stay connected!Would you like to receive the Connection newsletter via email? Sign-up at everettclinic.com/connection.

Join the conversation Customer Services:425-258-3900Monday – Friday: 7 am – 7 pm

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4027 Hoyt Ave., Everett ■■■■425-339-5401 ■■■■everettclinic.com/hearingaid

off

Manage your health when it’s convenient for youWith MyChart®, our online medical record system, you can access your health information whenever you need it, wherever you are. With MyChart you can:

■■ Schedule an appointment with your primary care provider

■■ view your health summary, current health conditions and health history

■■ view your lab results within hours of your test and trend them over time

■■ request specialty care appointments

■■ view current medications and request prescription renewals

■■ See upcoming and past appointments

■■ Make payments to your Clinic accounts

Sign up for MyChart by calling 425-258-3904, or ask the next time you come in for an appointment. Mobile app available—visit your mobile app store and search for MyChart.

now that the sun is getting closer to rising when you are, you might be ready to chase it. Without

starting your runs off on the right foot, however, small errors could lead to big issues.

1. Run softly. runners can land with a force up to three times their body weight per step. running with a quieter footfall reduces the load and decreases your risk of stress fractures. If you’re a loud runner, you might be landing with stiffened legs rather than using your joints as natural springs.

2. Point your kneecaps “forward” when you run. Place one uniquely colored sticker on the center of each kneecap, then have your friend take a video in front of you while you run (so you can observe yourself frame by frame) or run on a treadmill in front of a mirror. If your knees tilt inwards or rotate inwards, your kneecaps are at risk of not tracking properly (patellofemoral syndrome), and your lower leg muscles are at risk of being overworked (shin splints). Improving your gluteal strength (e.g. side lying scissors) will pull your thighs outward and better align your knees between your hips and ankles.

3. Keep “daylight” between your feet. If your steps are close enough to run on a tightrope, you are at an increased risk of IT band syndrome (excessive friction between your IT band and your knee) and patellofemoral syndrome. running on dirt and reviewing your footprints, or having a friend take a video of your running, can identify whether you have at least a few inches between your heels.

Finally, be sure to change your shoes every 300 miles or every six months, whichever comes first. And if any-thing happens to make you hang up your shoes, give us a call, and we’ll get you back on your feet!

Coupon valid through 6/26/15. present at time of order. Cannot be combined with any other offer or previous purchase.

At The Everett Clinic, your hearing aid purchase includes all follow-up service to adjust and maintain your optimum hearing over time. Make an appointment today.

Starting this spring, the Clinic will be using eSurveys (as well as some mailed surveys) to ask for feedback from patients who seek care with us.

The eSurvey program will allow patients to provide feedback more quickly than traditional mailed surveys. Just like our mailed surveys, the eSurvey is secure and

we will never share, sell or disclose email addresses. The eSurvey and mailed survey contain the same questions and are confidential, but patients may choose to provide their name if they are requesting a response to the feedback they provide.

Three Ways to Keep Spring in Your Stepby Dr. Douglas Pepple The Everett Clinic Sports Medicine

Never “play through the pain.” Always get foot or heel pain checked out!

A laugh or a whisper... hear every precious sound.

Get back to what you love! See a Sports Medicine expert in Orthopedics by calling 425-339-5447.

■■Dr. Jared Anderson ■■Dr. Douglas Pepple ■■Dr. Paul Reynolds ■■Dr. Thomas Skalley

And the eSurvey says…

The Everett Clinic is celebrating our 91st year of providing healthcare within our community and we would like to recognize some of our outstanding providers. As a patient of The Everett Clinic, you have a unique perspective on the work of our providers and we would like your help to recognize their work.

Share with us a time when your provider went above and beyond, how they have been meaningful in your life or how your life has improved through the care of your provider. We would like to honor them.

To nominate your provider, go to everettclinic.com/nominate or to The Everett Clinic Facebook page at facebook.com/TheEverettClinic and tell us your story. Thank you for helping us recognize the great work our providers do day in and day out.

Deadline for submission is Sunday, June 14 at 5 pm.

Honor your Provider